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Individual

BRANDIE LEA CLEVELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTA

Contact information

Practice address
1540 N 72ND ST, OMAHA, NE 68114-1924
(402) 398-3958
(402) 398-3955
Mailing address
15176 R ST, OMAHA, NE 68137-2470
(402) 331-4341
(402) 398-3955

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
722
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47-0707622-01
NE
Enumeration date
01/31/2007
Last updated
07/08/2007
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